Director of Facility Based Clinical Reimbursement

Hillcrest Health & Living; Bellevue (NE); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Paid time off

Tuition reimbursement

Career growth opportunities

Culture of Integrity, Compassion, and

Job summary

Hillcrest Health & Living seeks an experienced Director of Facility-Based Clinical Reimbursement (RN) to lead reimbursement across post-acute and long-term care communities. You will oversee MDS coordinators, ensure accurate MDS submissions, and optimize PDPM-related processes.

Key responsibilities include auditing MDS/RAI accuracy, developing policy, and partnering with clinical and financial leaders to align documentation with compliance, while traveling between facilities as needed.

Qualifications

• Active RN license in Nebraska (or compact state).
• Minimum 5 years of MDS/clinical reimbursement experience, including PDPM.
• Experience in post-acute care, long-term care, or skilled nursing facility management.
• Strong knowledge of Medicare/Medicaid regulations, RAI guidelines, and documentation requirements.
• Proven ability to lead and mentor multi-site reimbursement teams.
• Excellent analytical, organizational, and communication skills.
• Willingness to travel between facilities.

Responsibilities

• Provide leadership and oversight to facility MDS coordinators and reimbursement staff across all Hillcrest locations.
• Ensure accurate, timely completion and submission of MDS assessments in accordance with regulations.
• Monitor and analyze reimbursement data to identify trends, risks, and opportunities for revenue optimization.
• Serve as a subject matter expert on PDPM, Medicare, Medicaid, and payer-specific reimbursement systems.
• Develop and implement policies and procedures to ensure consistent documentation and coding practices.
• Partner with clinical and financial leaders to align care documentation with reimbursement compliance.
• Conduct regular audits of MDS accuracy, RAI processes, and supporting documentation.
• Support education, training, and competency development for facility reimbursement teams.
• Collaborate with regional and facility leadership to maintain regulatory readiness and survey compliance.
• Represent the reimbursement department in interdisciplinary and corporate-level meetings.

Skills

Leadership

Data analysis

Healthcare reimbursement

PDPM knowledge

Regulatory compliance

Travel readiness

Education

RN license (Nebraska or compact)

Job description

Director of Facility-Based Clinical Reimbursement

Hillcrest Health & Living is seeking an experienced and strategic Director of Facility-Based Clinical Reimbursement (RN) to lead and oversee all reimbursement-related functions across our post-acute and long-term care communities. This individual will serve as a key resource for ensuring compliance, accuracy, and optimization of the MDS and PDPM processes, while supporting our mission of Inspiring people to live their best lives.

Key Responsibilities

• Provide leadership and oversight to facility MDS coordinators and reimbursement staff across all Hillcrest locations.
• Ensure accurate, timely completion and submission of MDS assessments in accordance with federal and state regulations.
• Monitor and analyze reimbursement data to identify trends, risks, and opportunities for revenue optimization.
• Serve as a subject matter expert on PDPM, Medicare, Medicaid, and payer-specific reimbursement systems.
• Develop and implement policies and procedures to ensure consistent documentation and coding practices.
• Partner with clinical and financial leaders to align care documentation with reimbursement compliance.
• Conduct regular audits of MDS accuracy, RAI processes, and supporting documentation.
• Support education, training, and competency development for facility reimbursement teams.
• Collaborate with regional and facility leadership to maintain regulatory readiness and survey compliance.
• Represent the reimbursement department in interdisciplinary and corporate-level meetings.

Qualifications

• Current Registered Nurse (RN) license in the state of Nebraska (or compact state).
• Minimum 5 years of MDS/clinical reimbursement experience, including PDPM.
• Prior experience in post-acute care, long-term care, or skilled nursing facility management required.
• Strong knowledge of Medicare/Medicaid regulations, RAI guidelines, and clinical documentation requirements.
• Proven ability to lead, educate, and mentor multi-site clinical reimbursement teams.
• Excellent analytical, organizational, and communication skills.
• Ability to travel periodically between facilities.

Why Hillcrest

At Hillcrest, we believe in providing a career that helps you thrive—both professionally and personally. We offer:

• Comprehensive health, dental, and vision insurance options
• Paid time off
• Tuition reimbursement and student loan repayment for nurses
• Career growth and development opportunities
• A mission-driven culture centered on Integrity, Compassion, Respect, Teamwork, and Service